Improving HIV testing on the Acute Medical Unit at a Northwest Acute General Hospital.

Published Date: 01st April 2024

Publication Authors: Thomson-Glover. R

Conference Abstract. 

Background: Within our local area, rate of late diagnosis of persons living with HIV is higher (43-71%) than the national average (43%) and not currently covered by opt-out testing. The aim of this quality improvement project (QIP) was to improve HIV testing for people presenting to the Acute Medical Unit (AMU) with community acquired pneumonia (CAP) as per NICE guidelines.
Method(s): Data was collected on patients 18-70 years old admitted with CAP to AMU between March and May 2023. The plan, do, study, act (PDSA) model was followed. Three interventions were put in place between June and October 2023, with data collected each cycle. Firstly, an education session and posters were delivered to the AMU department, and email/WhatsApp information circulated. Secondly, the MicroGuide application was updated to include HIV testing within CAP assessment. Thirdly, a new Electronic Patient Record (EPR) order bundle for CAP was created, including HIV test. Data analysis was performed using Microsoft Excel. A Chi-squared test was used to determine any statistical significance.
Result(s): Data from 181 patients were included. 27% (12/44) of pre-intervention patients were tested for HIV during their admission, and 16% (5/32), 22% (10/46), 25% (15/59) of patients were tested following first, second and third interventions, respectively. No statistically significant difference was observed. Planned HIV tests (HIV test documented in clinical plan) increased: 27% (12/44) pre-intervention patients had a planned HIV test, compared with 22% (7/32), 26% (12/46) and 32% (19/59) during first, second and third cycles respectively. There were two cases in the final cycle where testing was considered but the decision documented was not to test. Most tests were requested by AMU consultants (52-86%) and medical take team (0-43%); tests requested by medical take team increased from 33% pre-intervention to 43% in final cycle.
Conclusion(s): We found an increasing trend of planned HIV tests, although this did not translate to a statistically significant improvement in number of tests performed. Our findings demonstrate an increasing awareness among staff of guidelines, although further progress is required for testing to become routine. HIV testing information on MicroGuide application and EPR CAP order bundle may encourage non-consultant doctors to consider HIV testing.

Kessler A.; Thomson-Glover R.; Et al. (2024). Improving HIV testing on the Acute Medical Unit at a Northwest Acute General Hospital. HIV Medicine. 25(Supp. 1), p.103. [Online]. Available at: https://dx.doi.org/10.1111/hiv.13628 [Accessed 19 December 2025].